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Reproductive Physiology Flashcards

1
Q

Define Puberty.

A

developmental phase between childhood and adulthood whereby functional maturation of reproductive glands and external genitalia mediated by changes in sex hormones (GnRH, FSH, LH)

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2
Q

What are does adrenarche generally occur?

A

6-8 years old

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3
Q

What is Adrenarche?

A

Adrenal gland secretes androgens (DHEA)

Androgens cause growth spurt, pubic hair growth begins and breast development starts

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4
Q

What is Menarche?

A

Onset of menstrual cycle

  • Mature ova produced
  • Increase GnRH –> Increase FSH and LH
  • Ovaries responsive to FSH
  • Ovaries (theca cells) respond to LH by androgen and oestrogen production
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5
Q

What age does Menarche begin?

A

10-16 years old

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6
Q

State 3 examples of female phenotypic changes in Puberty

A

Pubic hair

Growth and maturation of reproductive tract: uterus and external genitalia

Fat deposition: breasts, buttocks, thighs

Closure of epiphyseal plates: Stop growing (end of puberty)

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7
Q

State 3 examples of male phenotypic changes in Puberty

A

Testicular enlargement

Pubic hair growth

Growth of larynx

Deepening of voice

Increased bone mass

Increased mass and strength of skeletal muscle

Thickened skin

Increased and thickened hair on trunk, arms, legs and face

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8
Q

What is the term for the index used to measure secondary sexual characteristics in M or F?

What are the broad categories?

A

Tanner Stages (sexual maturity ratings for assessment of secondary sexual characteristics)

F:

  • Pubic hair (Ph1-6)
  • Breast development (B1-5)

M:

  • Pubic hair (Ph1-6)
  • Genital development (G1-5)
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9
Q

What is the Female Monthly Sexual Cycle?

A

Ovarian Cycle + Menstrual Cycle

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10
Q

What are the two phases of the Ovarian cycle?

A

Follicular phase

Luteal phase

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11
Q

Which of the following does not occur in the follicular phase?

A. Days 1-14

B. Raised progesterone and oestrogen

C. Maturation of the egg

D. Ovulation signals its end

A

B. Raised progesterone and oestrogen

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12
Q

Which of the following does not occur in the follicular phase?

A. Days 1-14

B. Follicle produces oestrogen

C. Maturation of the egg

D. Ovulation signals its beginning

A

D. Ovulation signals its beginning

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13
Q

Which of the following is not true for the luteal phase?

A. Days 15-28

B. Development of corpus luteum

C. Corpus luteum produces Progesterone only

D. Induces preparation of reproductive tract for pregnancy

A

C. Corpus luteum produces Progesterone only

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14
Q

Which of the following is not true for the luteal phase?

A. Days 15-28

B. Development of corpus luteum

C. Corpus luteum produces Progesterone and Oestrogen

D. Induces preparation of reproductive tract for menstruation

A

D. Induces preparation of reproductive tract for menstruation

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15
Q

In the follicular phase, which of the following is true?

A. GnRH decreases prior to FSH and LH rise

B. Rising FSH and LH stimulates oestrogen

C. Oestrogen levels inhibit both FSH and LH

D. Inhibin inhibits H release only

A

B. Rising FSH and LH stimulates oestrogen

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16
Q

Outline the follicular phase of the hormonal control of the female monthly sexual cycle.

A

GnRH rise from Hypothalamus

FSH + LH rise at beginning of cycle from Anterior Pituitary gland

Rising FSH + LH stimulates oestrogen production

Oestrogen inhibits FSH but not tonic LH

Inhibin also inhibits FSH

Moderate oestrogen stimulated positive feedback ≈ more oestrogen

Note: Menstrual phase (4 days) causes endometrium disintegration

Note: Proliferative phase (6-14 days) allows thickening of endometrium due to oestrogen levels

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17
Q

Outline the luteal phase of the hormonal control of the female monthly sexual cycle.

A

High oestrogen ≈ elevated LH (positive feedback) ≈ LH burger ≈ ovulation

Ruptured follicle becomes corpus luteum

Corpus luteum produces Progesterone and oestrogen to inhibit LH and FSH production

10 days.. corpus luteum degenerate and progesterone and oestrogen levels significantly drop with FSH and LH no longer repressed

FSH and LH increased as new cycle begins

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18
Q

What is the major phase regarding menstrual effects which occurs during the Luteal hormonal phase?

A

Secretory (Progestational) phase

Progesterone stimulates maintenance and development of endometrium for correct environment should ovum fertilisation occur

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19
Q

State 2 functions of the corpus luteum

A

Oestrogen production = endometrium thickening

Progesterone production = endometrium development and maintenance

Inhibition of LH and FSH

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20
Q

What is the menopause?

A

Last menstrual period due to reduced oestrogen and oocyte supply diminished with 12 months of cessation of periods occurring after 45 years, mean age 51

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21
Q

Give 3 symptoms of the menopause

A 
Amenorrhea (> 12 months)
Hot flushes 
Low mood
Night sweats 
Hirsutism 
Reduced libido 
Vaginal atrophy 
Vaginal dryness
Irregular menses
Dry skin and dry hair
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22
Q

Give a suggested reason for the aetiology of Menopause.

A
  • Oocyte depletion (low quality)
  • Insensitive to LH and FSH
  • Age-related CNS changes cause reduced GnRH secretion
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23
Q

State 3 potential complications of the menopause.

A
  • CVD
  • CVI
  • OP
  • Breast Ca risk reduced
  • Hirsutism
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24
Q

What is the andropause?

A

symptoms/decline in general health associated with decrease in testosterone in older men (> 50 years old)

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25
Give a suggested aetiological cause of the andropause.
- Gonadal LH insensitivity - Androgen production reduced - Serum LH and FSH increased
26
State 5 functions of the female reproductive system.
- Ova production - Receive sperm - Capacitation - Transport sperm and ova to site of fertilisation - Gestation - Parturition - Nourishment of infant by lactation
27
What is the primary function of the Ovaries with regards to reproductive functions? A. Site of fertilisation B. Receptacle for sperm and birth canal C. Allow sperm through to uterus D. Maturation and release of ova
D. Maturation and release of ova
28
What is the primary function of the Uterus with regards to reproductive functions? A. Site of fertilisation B. Receptacle for sperm and birth canal C. Allow sperm through to uterus D. Maintain foetus during gestation and expel in postpartum
D. Maintain foetus during gestation and expel in postpartum
29
What is the primary function of the Oviducts with regards to reproductive functions? A. Site of fertilisation B. Receptacle for sperm and birth canal C. Allow sperm through to uterus D. Maintain foetus during gestation and expel in postpartum
A. Site of fertilisation
30
What is the primary function of the Vagina with regards to reproductive functions? A. Site of fertilisation B. Receptacle for sperm and birth canal C. Allow sperm through to uterus D. Maintain foetus during gestation and expel in postpartum
B. Receptacle for sperm and birth canal
31
What is the primary function of the Vaginal opening with regards to reproductive functions? A. Allow penis in/baby out B. Receptacle for sperm and birth canal C. Allow sperm through to uterus D. Maintain foetus during gestation and expel in postpartum
A. Allow penis in/baby out
32
What is the primary function of the Cervix with regards to reproductive functions? A. Allow penis in/baby out B. Receptacle for sperm and birth canal C. Allow sperm through to uterus D. Maintain foetus during gestation and expel in postpartum
C. Allow sperm through to uterus
33
What is oogenesis?
form of gametogenesis in which mitotic and meiotic divisions occur to produce an ovum (female gamete)
34
Outline the process of Oogenesis.
Primordial germ cells arrest in meiosis I = primary oocytes Primary oocytes arranged in gonads in clusters around follicular cells --> primordial follicles Stages: Pre-Antral: 1º oocyte grows Follicular cells grow and proliferate to form stratified cuboidal epithelium (= granulosa cells) Granulosa cells secrete glycoproteins to form zona pellucida around 1º oocyte CT differentiates to become theca folliculi, responsive to LH --> secrete androgens Antral: Fluid-filled spaces form between granuloa cells ≈ secondary follicles which become dominant under influence of FSH, LH and oestrogen Pre-ovulatory stage: LH burger induces pre-ovulatory stage Meiosis II occurs with first polar body creating two and secondary oocyte arrests in metaphase of meiosis II, 3 hours prior to ovulation
35
Which is the primary reproductive function of the penis? A. Produce sperm B. Suspend testes C. Secrete semen to suspend and sustain sperm D. transfer sperm to female
D. transfer sperm to female
36
Which is the primary reproductive function of the scrotum? A. Produce sperm B. Suspend testes C. Secrete semen to suspend and sustain sperm D. transfer sperm to female
B. Suspend testes
37
Which is the primary reproductive function of the accessory glands? A. Produce sperm B. Suspend testes C. Secrete semen to suspend and sustain sperm D. transfer sperm to female
C. Secrete semen to suspend and sustain sperm
38
Which is the primary reproductive function of the testes? A. Produce sperm B. Suspend testes C. Secrete semen to suspend and sustain sperm D. transfer sperm to female
A. Produce sperm
39
Outline the route by which sperm exits the scrotum
SEVEN UP Seminiferous tubules Epididymis Vas Deferens Ejaculatory duct NOTHING Urethra Penis
40
State the 4 stages of Sexual Arousal.
1. Excitement: sexual awareness 2. Plateau: Excitement intensification 3. Orgasm: Intense physical pleasure 4. Resolution: Post-orgasm refractory period
41
Which of the following is not a part of the plateau phase of Sexual Arousal? A. Tenting effect B. Enlarge upper 1/2 vagina C. Excitement intensification D. Testicular vasocongestion + erection
D. Testicular vasocongestion + erection
42
Which of the following is not a part of the plateau phase of Sexual Arousal? A. Tenting effect B. Enlarge upper 1/2 vagina C. Excitement intensification D. Return of body to pre-excitement state
D. Return of body to pre-excitement state
43
Which of the following is not a part of the excitement phase of Sexual Arousal? A. Vaginal lubrication B. Vasodilation of vagina C. Testicular vasocongestion D. Tenting effect of vagina
D. Tenting effect of vagina
44
Which of the following is not a part of the Resolution phase of Sexual Arousal? A. Relaxation B. Return to pre-excitement states C. Testicular vasocongestion D. Temporal refractory period
C. Testicular vasocongestion
45
Outline the mechanism of the erection reflex.
1. Psychogenic/Somatogenic stimulation 1) PSNS stimulation - Secretion via glands - Erection 2) Sympathetic stimulation - Inhibition to penile arterioles - Penile arteriolar dilation
46
Outline the mechanism of ejaculation.
1. Stimulation of mechanoreceptors in glans of penis 2. Sympathetic response - Contraction of prostate - Contraction of reproductive ducts - Contraction of seminal vesicles - Skeletal muscle contraction --> Semen into urethra
47
List the components of Semen
Prostatic fluid + Seminal Fluid + Sperm
48
Outline the stages of IVF
1) Pre-fertilisation: - Oocyte removed (6-24 hours viable) - Spermatozoa removed (24-48 hours viable) - Capacitation (remove glycoprotein coat + whip-like tail movements + acrosomal reaction) 2) Fertilisation - Allurin released by ovum = attract sperm - Bind (fertilin) to 2º oocyte + acrosomal reaction allows tip to burrow into zona pellucida
49
What chemoattractant molecule is released by the ovum to attract sperm?
Allurin
50
What protein does sperm use to bind to the 2º oocyte.
Fertilin
51
State the primary function of the sperm tail in fertilisation
- Locomotion | - Blocking other sperms to prevent polyspermy
52
What are the types of block to polyspermy?
1) 1º Block: Egg membrane depolarises ≠ sperm fusion 

 | 2) 2º Block: Changes to zona pellucida (cortical reaction) making sperm binding difficult 

53
Following fertilisation, what occurs to the 2º oocyte?
secondary oocyte continues from metaphase of meiosis II to finish meiosis and 2nd polar body formed and extruded from egg, ensuring female pronucleus is haploid 

54
Outline the conceptus journey.
Fertilisation --> Cleavage --> Morula (16 cell mulberry) --> Blastocyst
55
Where does the blastocyst implant?
Uterine epithelium with trophoblast cells growing into the endometrium, releasing nutrients for the embryo
56
What day does the blastocyst become buried in the uterine lining by?
Day 12
57
Outline the process of placental formation and development.
Formation: 1. Trophoblast proteases digest and allow trophoblast to embed into uterine endometrium 2. Trophoblast induces decidualisation of endometrium (vascularisation + nutrient storage) 3. Trophoblast buried into uterine lining by day 12 Development: 1. Trophoblast differentiates into multinucleate syncitiotrophoblasts invading and breaking down capillaries to form cavities with maternal blood 2. Embryo sends capillaries into syncitiotrophoblast projections = placental vili Note: Each villus contains foetal capillaries separated from maternal blood by thin layer of tissue thus no direct contact 3. Exchange of substances via functionalists; 5th week of pregnancy
58
Which of the following hormones are released from the blastocyst in the detection of pregnancy? A. Oestrogen B. Progesterone C. ßhCG D. PTHrp
C. ßhCG
59
This is the function of which of the following hormones? 'Prolongs corpus luteum of pregnancy to produce oestrogen and progesterone' A. Oestrogen B. Progesterone C. ßhCG D. PTHrp
C. ßhCG
60
This is the function of which of the following hormones? 'Stimulates growth of myometrium' A. Oestrogen B. Progesterone C. ßhCG D. PTHrp
A. Oestrogen
61
This is the function of which of the following hormones? 'Stimulates development of mammary gland ducts' A. Oestrogen B. Progesterone C. ßhCG D. PTHrp
A. Oestrogen
62
This is the function of which of the following hormones? 'Stimulates development of mammary gland ducts' A. Oestrogen B. Progesterone C. ßhCG D. PTHrp
A. Oestrogen
63
This is the function of which of the following hormones? 'Suppress uterine contractions' A. Oestrogen B. Progesterone C. ßhCG D. PTHrp
B. Progesterone
64
This is the function of which of the following hormones? 'Promote formation of mucous plug' A. Oestrogen B. Progesterone C. ßhCG D. PTHrp
B. Progesterone
65
This is the function of which of the following hormones? 'Stimulate development of mammary milk glands for lactation' A. Oestrogen B. Progesterone C. Prolactin D. PTHrp
C. Prolactin
66
This is the function of which of the following hormones? 'Reduce maternal glucose utilisation, increasing plasma FA, increase glucose and FA available for foetus' A. Oestrogen B. Progesterone C. hCS D. PTHrp
C. hCS
67
This is the function of which of the following hormones? 'Mobilise Maternal calcium if calcium deficient' A. Oestrogen B. Progesterone C. hCS D. PTHrp
D. PTHrp
68
This is the function of which of the following hormones? 'Soften cervix and loosen pelvic connective tissue' A. Oestrogen B. Relaxin C. hCS D. PTHrp
B. Relaxin
69
This is the function of which of the following hormones? 'Stimulate DHEAS production by foetal adrenal cortex' A. placental CRH B. Relaxin C. hCS D. PTHrp
A. placental CRH
70
At what stage does the placenta take over from the Corpus Luteum in production of Oestrogen and Progesterone?
10 weeks
71
How soon after postpartum does menstruation begin providing there are no interventions?
4-6 weeks
72
State the 4 stages of Sexual Arousal.
1. Excitement: sexual awareness 2. Plateau: Excitement intensification 3. Orgasm: Intense physical pleasure 4. Resolution: Post-orgasm refractory period
73
Which of the following is not a part of the plateau phase of Sexual Arousal? A. Tenting effect B. Enlarge upper 1/2 vagina C. Excitement intensification D. Testicular vasocongestion + erection
D. Testicular vasocongestion + erection
74
Which of the following is not a part of the plateau phase of Sexual Arousal? A. Tenting effect B. Enlarge upper 1/2 vagina C. Excitement intensification D. Return of body to pre-excitement state
D. Return of body to pre-excitement state
75
Which of the following is not a part of the excitement phase of Sexual Arousal? A. Vaginal lubrication B. Vasodilation of vagina C. Testicular vasocongestion D. Tenting effect of vagina
D. Tenting effect of vagina
76
Which of the following is not a part of the Resolution phase of Sexual Arousal? A. Relaxation B. Return to pre-excitement states C. Testicular vasocongestion D. Temporal refractory period
C. Testicular vasocongestion
77
Outline the mechanism of the erection reflex.
1. Psychogenic/Somatogenic stimulation 1) PSNS stimulation - Secretion via glands - Erection 2) Sympathetic stimulation - Inhibition to penile arterioles - Penile arteriolar dilation
78
Outline the mechanism of ejaculation.
1. Stimulation of mechanoreceptors in glans of penis 2. Sympathetic response - Contraction of prostate - Contraction of reproductive ducts - Contraction of seminal vesicles - Skeletal muscle contraction --> Semen into urethra
79
List the components of Semen
Prostatic fluid + Seminal Fluid + Sperm
80
Outline the stages of IVF
1) Pre-fertilisation: - Oocyte removed (6-24 hours viable) - Spermatozoa removed (24-48 hours viable) - Capacitation (remove glycoprotein coat + whip-like tail movements + acrosomal reaction) 2) Fertilisation - Allurin released by ovum = attract sperm - Bind (fertilin) to 2º oocyte + acrosomal reaction allows tip to burrow into zona pellucida
81
What chemoattractant molecule is released by the ovum to attract sperm?
Allurin
82
What protein does sperm use to bind to the 2º oocyte.
Fertilin
83
State the primary function of the sperm tail in fertilisation
- Locomotion | - Blocking other sperms to prevent polyspermy
84
What are the types of block to polyspermy?
1) 1º Block: Egg membrane depolarises ≠ sperm fusion 

 | 2) 2º Block: Changes to zona pellucida (cortical reaction) making sperm binding difficult 

85
Following fertilisation, what occurs to the 2º oocyte?
secondary oocyte continues from metaphase of meiosis II to finish meiosis and 2nd polar body formed and extruded from egg, ensuring female pronucleus is haploid 

86
Outline the conceptus journey.
Fertilisation --> Cleavage --> Morula (16 cell mulberry) --> Blastocyst
87
Where does the blastocyst implant?
Uterine epithelium with trophoblast cells growing into the endometrium, releasing nutrients for the embryo
88
What day does the blastocyst become buried in the uterine lining by?
Day 12
89
Outline the process of placental formation and development.
Formation: 1. Trophoblast proteases digest and allow trophoblast to embed into uterine endometrium 2. Trophoblast induces decidualisation of endometrium (vascularisation + nutrient storage) 3. Trophoblast buried into uterine lining by day 12 Development: 1. Trophoblast differentiates into multinucleate syncitiotrophoblasts invading and breaking down capillaries to form cavities with maternal blood 2. Embryo sends capillaries into syncitiotrophoblast projections = placental vili Note: Each villus contains foetal capillaries separated from maternal blood by thin layer of tissue thus no direct contact 3. Exchange of substances via functionalists; 5th week of pregnancy
90
Which of the following hormones are released from the blastocyst in the detection of pregnancy? A. Oestrogen B. Progesterone C. ßhCG D. PTHrp
C. ßhCG
91
This is the function of which of the following hormones? 'Prolongs corpus luteum of pregnancy to produce oestrogen and progesterone' A. Oestrogen B. Progesterone C. ßhCG D. PTHrp
C. ßhCG
92
This is the function of which of the following hormones? 'Stimulates growth of myometrium' A. Oestrogen B. Progesterone C. ßhCG D. PTHrp
A. Oestrogen
93
This is the function of which of the following hormones? 'Stimulates development of mammary gland ducts' A. Oestrogen B. Progesterone C. ßhCG D. PTHrp
A. Oestrogen
94
This is the function of which of the following hormones? 'Stimulates development of mammary gland ducts' A. Oestrogen B. Progesterone C. ßhCG D. PTHrp
A. Oestrogen
95
This is the function of which of the following hormones? 'Suppress uterine contractions' A. Oestrogen B. Progesterone C. ßhCG D. PTHrp
B. Progesterone
96
This is the function of which of the following hormones? 'Promote formation of mucous plug' A. Oestrogen B. Progesterone C. ßhCG D. PTHrp
B. Progesterone
97
This is the function of which of the following hormones? 'Stimulate development of mammary milk glands for lactation' A. Oestrogen B. Progesterone C. Prolactin D. PTHrp
C. Prolactin
98
This is the function of which of the following hormones? 'Reduce maternal glucose utilisation, increasing plasma FA, increase glucose and FA available for foetus' A. Oestrogen B. Progesterone C. hCS D. PTHrp
C. hCS
99
This is the function of which of the following hormones? 'Mobilise Maternal calcium if calcium deficient' A. Oestrogen B. Progesterone C. hCS D. PTHrp
D. PTHrp
100
This is the function of which of the following hormones? 'Soften cervix and loosen pelvic connective tissue' A. Oestrogen B. Relaxin C. hCS D. PTHrp
B. Relaxin
101
This is the function of which of the following hormones? 'Stimulate DHEAS production by foetal adrenal cortex' A. placental CRH B. Relaxin C. hCS D. PTHrp
A. placental CRH
102
At what stage does the placenta take over from the Corpus Luteum in production of Oestrogen and Progesterone?
10 weeks
103
How soon after postpartum does menstruation begin providing there are no interventions?
4-6 weeks

Obstetrics and Gynaecology (8 decks)

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